I was informed today about an e-cigarettes article in South China Morning Post referring to one of my studies with the conclusion that e-cigarettes are equally harmful to tobacco cigarettes. In response to this, I decided to send a letter to the journalist signing this article.

Start of letter

Dear Mrs. Gonzales,

I was informed about your article in South China Morning Post about e-cigarettes, in which you mentioned the findings of one of my studies.

In the article, you mention: "A recent study by Greek cardiovascular specialist Dr Konstantinos Farsalinos found that e-cigarettes can cause lung damage and are not safer than regular tobacco cigarettes."

Allow me to strongly object to the conclusion drawn in this sentence, which is not associated with the findings of my study. Most probably you refer to the recent analysis of e-cigarette liquids, in which we detected diacetyl and acetyl propionyl. The study was presented as a poster in GFN 2014 Conference (http://gfn.net.co/downloads/2014/posters/122%20Farsalinos%20%20-%20DA_AP.pdf). However, the poster (as well as the manuscript which has already been submitted for publication in a medical journal) specifically mentions that: "They [diacetyl and acetyl propionyl] were 2-times higher than the strict NIOSH-defined safety limits (Figure 4) but 100 and 10 times lower compared to smoking respectively".

Therefore, your conclusion that e-cigarettes "are not safer than regular tobacco cigarettes" is not supported by my study or any other published study by any researcher. Even if the levels found were similar to tobacco cigarettes, we should not forget that there are many other toxic tobacco-related chemicals which are completely absent or present in minimal quantities in e-cigarettes (e.g. polycyclic aromatic hydrocarbons, nitrosamines, phenols etc.). Thus, it is highly unlikely that even the worst-quality e-cigarette can ever be as harmful as tobacco cigarettes.

Smoking is a very sensitive matter because of the significant adverse health implications. It is an ethical obligation of scientists and the media to properly and responsibly inform smokers about e-cigarettes being a less harmful alternative to tobacco cigarettes. To the best of my knowledge, no scientist has ever supported that e-cigarettes are absolutely safe. However, current evidence overwhelmingly supports that they are by far less harmful that tobacco cigarettes. This is the most crucial issue and the most important information that every smoker needs and deserves to know. My recent study confirms this, and is important for an additional reason: it detected an avoidable risk, which can be easily removed and thus make e-cigarettes even safer.

I urge you to reconsider the conclusion mentioned in your article and I would be glad to answer to any question you may have concerning this and other studies.

End of letter.

Another quote from the same article stated:- "Liquid nicotine can be fatal in small amounts, Mui points out. A tablespoon of 10 per cent nicotine concentration liquid can kill an adult, while a teaspoon can kill a child. This liquid can be inhaled, ingested, or absorbed through the skin and eyes."

There are many products on general that could be potentially fatal if consumed, that is why they are bottled and labelled appropriately and in accordance with CLP regulations. However, there are two points that have been overlooked, probably because of the lack of research conducted by the journalist.

The maximum concentration that can be sold retail legally in the UK is 7.5%, above which a Poisons Licence is required. The average concentration in most eliquid on sale is between 0.9% and 2.4% (9mg/ml and 24mg/ml).

More importantly, the LD50 (Lethal Dose that would by estimate prove fatal to 50% of people) was reviewed and revised; the official figure used by EU regulatory authorities is 50mg/kg of body weight, that would mean 41ml of 2.4% eliquid for someone weighing just 20kg, the equivalent of over eight teaspoons. Given that Nicotine liquid has a pronounced emetic effect (vomit-inducing) it would be very difficult to consume such an amount accidentally.

The type of scaremongering we see from some of those opposed to vaping is appalling and displays a complete disregard for the honest, scientific research and testing that has been undertaken so far and which continues undeterred.Electronic cigarettes are more and more being perceived for what they really are, a far less harmful delivery method for those who choose to use Nicotine recreationally. Just as people have the right to choose to drink alcohol, consume caffeine, eat 'unhealthy' food, partake in dangerous sports, and generally live the way they want, so they should be afforded the rightful freedom of choice to use Nicotine. One day Ecigs will be hailed as the greatest ever tool of smoking harm reduction; already there are millions of users worldwide and millions less smokers likely to fall prey to the often fatal diseases that for many decades have been caused by smoking tobacco cigarettes.

"If all the smokers in Britain stopped smoking cigarettes and started smoking e-cigarettes we would save five million deaths in people who are alive today. It’s a massive potential public health prize."- Prof. J Britton, Royal College of Physicians

One good source of information is the E-cigarette Politics website where you can find a wealth of material, some of it might shock you.

Just as the Genie appears when you rub the magic lamp, so the truth will appear when you look hard enough.